As many said, Newt has baggage, but what does it say about the former Governor of MA that he still hasn't renounced the same thing?

Ted Kennedy went from saying the placement of replacement senators should be a governor's responsibility (when the gov was a Democrat) to saying it should be up to the people (when the gov was a Republican) and still remained hugely popular.

The Democrats are going to get their nominee. Even the NYT is crowing about Romney's "inevitability" today. There is a lot to like for them - either they get Obama part two or another Democrat as president.

"[T]here are known knowns; there are things we know we know.We also know there are known unknowns; that is to say we know there are some things we do not know.But there are also unknown unknowns – there are things we do not know we don't know." - Rumsfeld

I agree, but I have not seen any method that would not lead to less healthcare or higher cost for everyone else. The question is: is it worth reducing health care for everyone forever to insure the uninsured?

Gingrich Memo: While in theory the plan should be affordable if the whole state contributes to the cost, the reality is that Massachusetts has an exhaustive list of health coverage regulations prohibiting insurers from offering more basic, pared-down policies with higher deductibles.

Those antagonistic to Romney on the issue of healthcare should know how the final Massachusetts legislation differed from his plan. Notably, Romney opposed two mandates: the employer mandate that further tied insurance to the workplace, and the minimum plan coverage mandates that boosted the premiums for a "basic" plan above that necessary to protect the taxpayer.

Governor Romney is often asked what he would change about RomneyCare, or what he would have done differently. Romney’s first response is “I would re-institute my vetoes.” Many voters don’t realize that Romney vetoed significant portions of the bill in an attempt to control costs and unnecessary regulation. Unfortunately, all of Romney’s vetoes were later overridden by the Massachusetts legislature which was 87% Democrats at the time. Here is a list of provisions that Romney vetoed, or things he would otherwise change.

Not to play thread sheriff, and Freder's definitely not above ad hominem himself, but this would seem to have worked just fine by ending the sentence after "doing". Wasn't Christmas just a couple days ago?

Worse in what way? Are the people in the U.S. healthier than those in the rest of the developed world. Do we have better longevity. Do we spend less overall on healthcare than other countries?

The answer to both questions is no and hell no. We spend way more (as a percent of our GDP) than any other country for results that are not significantly better, even for those who have good insurance. Someone without insurance (and that number is shockingly high) is much worse off in this country than they would be in any other developed country you care to mention.

Romney and a Republican dominated legislature will spend the next four years modifying Obamacare to preserve it. Obama will get the credit. Healthcare costs will explode, quality will sink, and innovation in healthcare will stagnate. The Republicans will get credit for the problems.

In this debate, the discourse got very warped with ultraconservatives and the wilder libertarian & Tea Party kooks going past saying that one size fits all Obamacare with an individual mandate to pay for every aspect of heathcare decided on by Nancy Pelosi and minions to be foisted on all 50 states....was a clarion call to oppose ANY individual mandate.

The individual mandate in any context became their ideological bete noire..not Obama's plan. In the name of Freedom!! - some of the worse far right whack jobs went to abandoning fiscal conservativism and endorsing Free Riders. Those who would want the Freedom! to not spend 9,000 dollars a year on health insurance but thought buying a 80,000 dollar party boat if they "thought at age 50 that was a wise use of their money from the plumbing business they had...And the answer given the whack jobs varied if the 50 year old uninsured owner of the 80K Party boat was in a bad accident or diagnosed with a heart needing a transplant:

1. Ron Paul libertarian - Well, he wouldn't die because good doctors, nurses, and hospitals would ensure he got the right medical care - because they would choose to. But it is their right to refuse care. And he could be asked to sell the boat to pay for part of the costs...but the state doesn't have the right to make him pay.2. Far right nut - Ah don't care. All I know is Ahm agin' gummint telling me what to do..and in mah mind that Romney is trammeling on mah rights. Our pioneers didn't need no health insurance!3. Evangelical - Whatever on the healthcare. The important thing is Romney is a heretic and sweet baby Jesus hates him!4. Compassionate conservative - Well, I oppose any effort of democrats or RINOs to impose a new tax. Having to pay for anything by government decree is a tax. And an individual mandate is a tax that will kill jobs, like on the makers of Air Jordans and luxury power boats costing 80K. Saint Reagan himself would say so. But we can't just let some 50 year old die on the street or be denied a heart transplant on some trivial matter like him wishing to enjoy life. The government should pay for it without raising taxes..just get rid of all the other waste fraud and abuse - and borrow the remainder from China.

In the future, people who remember will badly miss the healthcare they have today. The young won't know what they've lost. Regardless of how poor it is, it will still become something that is untouchable forever. Well done Obama voters. At least he's not a crazy old man with his finger on the trigger like Reagan

I care to mention a baby that's born at 21 weeks premature in GB. That baby will die with both the personnel and equipment to give it an excellent chance at survival in the same ward.

First of all, that policy is guidance, not an absolute mandate.

Secondly, if an uninsured woman (assuming she is not vastly wealthy) delivered at 21 weeks in this country, she has two choices, seek treatment for the baby which will probably bankrupt her or let the baby die--which it probably will anyway as only a handful of 21 week deliveries have survived.

BTW, my niece was born at 6 months and 2 lbs under the NHS in England. She received excellent care and is now 19 years old.

"What does the financial crisis in Europe have to do with the healthcare systems there?"

Let's see, they don't have the money to pay for all the things that they've promised to people will be "free". It's not just healthcare, it's a lot of things. And some countries are doing better than others because they have more fiscal discipline. But the heart of the problem is promising "free" stuff to people when that stuff is actually very expensive. You're setting up expectations that can't possibly be met. Pick any two of the three:

The number of miles we drive every years, an thus die in car accidents, has a large affect.

While our highway death rate (12.3 per 100,000) is higher than most European countries (which hovers around 5-7 per 100,000 in most countries) it is still low enough that it is not a significant factor in longevity.

Americans lead the world in life expectancy when violent (non-health related) causes are factored out. This means that even though we have some of the the most unhealthy lifestyles on earth, out healthcare is so good it more than makes up for it. Facts matter.

This is what makes me hesitant about both Newt and Mitt. They said this kind of stuff, and now when asked about it, they assert how they have stayed entirely consistent throughout and then go on to make some convoluted rationalization. Just say, "I was wrong, bitch." (I like idiomatic usage.)

Americans, by most measures, are far healthier and don't have to contend with death panels, which really tend to undermine one's health.

What measures would those be?

Development of new drugs and technologies, actual access to good care (as opposed to waiting six months (or years) for elective (or necessary) surgery), quality of care - The Blonde regularly treated people coming over from Europe and other parts of the world who couldn't imagine why we were giving up our system for the DMV-style maign neglect they got at home.

The Euros like to point to life expectancy and infant mortality as measures of their superiority, but those are dependent as much on economics as anything else.

Universal coverage is not insurance. Insurance is where an individual weighs his risks and the cost of insuring those risks and then decides to purchase insurance against potential losses which could include property, health and life casualties.

The MA healthcare plan is all based on 'preventative care' to bring down costs. In fact, emergency visits have gone up, and MA citizens are not getting any healthier just because they can get a checkup with a $10 copay. They are still ignoring their doctor's advice to eat better and lose weight; so far there's no evidence that severe illness detection is any better under the plan (I'd argue that technology is improving detection more than regular doctor's visits); and without competition the small pool of health care insurance providers are jacking up costs (some of which are to offset the cost of keeping up with onerous MA regulations).

Just providing health insurance might not work. If people are going to ignore their doctors anyway, then I favor a vouchers plan similar to what Paul Ryan proposed for Medicare. This endless spiral of expanding expanding entitlements and then regulating the providers is nihilistic and ultimately futile.

Americans lead the world in life expectancy when violent (non-health related) causes are factored out.

Even if you factor out those deaths (and violent and accidental deaths aren't necessarily non-health related as the deaths could be attributed to health care or lack thereof received after the injury--not to mention the statistical methods used for the study are controversial), the life expectancy in the U.S. is not significantly better than in other countries (in most cases less than a year difference). We spend about a third more on health care than the next closest country (France) and almost three times as much as the U.K. with its despised (by people in the U.S., certainly not the U.K.) NHS.

bagoh20 said..."I agree, but I have not seen any method that would not lead to less healthcare or higher cost for everyone else. The question is: is it worth reducing health care for everyone forever to insure the uninsured?"===============No, the question is: "Can the healthcare system - both public and privately paid - survive an ever-growing number of Free Riders and continue to provide affordable quality care?"

Some reactionaries advocate that each young person should have the freedom not to be "forced" into the heathcare insurance system until they are good and ready...spending their and their employers contributions on other things until they get much older and try joining a smaller, much older and higher risk pool that will have astronomically high cost.Or they say - whenever a person gets seriously sick or in an major accident is when the Free Rider can "opt in".

You also have a large population of working poor , part-timers, self employed that can afford part of a yearly heathcare insurance bill, but not all of it. So more and more, they have opted for not paying anything for healthcare and hiding all their assets from bankruptcy, or spending what they get with no savings or investments for the future.

Even pretty well-off people are trying to protect their own asses by shifting the burden to taxpayers and the private market insured people in - for them not paying anything in, but getting all the care they need if something happens.

Some are even forced to..a well off man I know is uninsurable because of a pre-existing heart condition. So his accountant and lawyer devised an asset protection system from medical bill collectors - trusts, real estate placed in the name of relatives, no stocks or significant bank account funds tied to him. Cayman Island account, transferable securities. Downside is no credit. He has to pay cash or debit for everything, including debit cards he has others buy and fill with his cash so the money transfers would never show up if his heart starts acting up and the bill collectors descend. Only reason I found out was his car died in a city we were doing business in and he had to rent a car and needed a credit card - so he rented on mine after telling me of his predicament. He didn't want to be a free rider, but was forced to be. (But all the extra money he had to spend on other goodies instead of health insurance was 'somewhat a compensation for all the hassle')

Joe Schmoe said...This is what makes me hesitant about both Newt and Mitt. They said this kind of stuff, and now when asked about it, they assert how they have stayed entirely consistent throughout and then go on to make some convoluted rationalization.====================Both Romney and Newt take the stance against Free Riders getting their healthcare subsidized through taxpayers or other insured parties. That is a quite defensible position. And in Massachusetts, the approval of the system devised by MIT economists, Romney, the health provider industry, and the Democrats runs 3-1.Romney goes on to say Masscare has too many bells and whistles, cost containment needs to get rid of some provisions Dems added that hinders it...but while he strongly believes other states should do what is best for them - healthcare is in dire need of systemic changes or it will fail most Americans eventually, and Romneycare is progress in fixing some of the big problems.

Newt also strongly defends the idea that the rest of the population should not be tapped to provide for the free healthcare of individuals that can afford to pay in, but refuse. And correctly states that given the legal structure forces the system to care for the uninsured, the crazier right wingers that say "let Freedom-Loving mean the uninsured bleed out on the streets or die of untreated pneumonia on the hospital doorstep - are misinformed on the realities.

Freder - If you want to compare healthcare systems, you not only need to adjust for violent deaths and accidents, but for diet, lifestyle and demographics as well. It's not an apples to apples comparison you're making.

"No, the question is: "Can the healthcare system - both public and privately paid - survive an ever-growing number of Free Riders"

The more government involvement there is the more free riders you get. In fact, many who would otherwise be responsible will find that being so is a suckers game.

Much of the reason that people don't currently buy health care is that government requirements make it too expensive. They can't buy what they need.

An analogy would be if the government only permitted people to buy a Prius. A lot of people would not have cars. What would we do about that? Require them to buy one so that the cost would go down? Would the cost go down?

Canada's system only works because we're their neighbors. It wouldn't work otherwise. That poor guy they sent home with a fist-sized hole in his head for months after his accident. Poor guy was afraid his brain would fall out. Took almost a year for them to put a plate in his head.

What's the over/under on the number of time a liberal talking point must be refuted on this blog before it stops being deployed? Is it a finite number?

Yet again the point must be made that general life-expectancy figures are not valid proxies for the quality of health care in a country. What is a valid proxy is life expectancy conditional on having a health problem. By that indicator, the US health-care system is the world's best, unambiguously.

On page 8 of this study you can find the 5-year survival rates for 23 different cancers in 15 different countries of varying income levels. You will see that the US is at the top by wide margins for 21 of those cancers, and a very close second (to Switzerland) for the other two.

The general claim that the US can both improve health outcomes and reduce costs by centralizing medical paperwork is so absurd that it can't possibly be an honest mistake.

The more government involvement there is the more free riders you get. In fact, many who would otherwise be responsible will find that being so is a suckers game.

This is both correct and goes a long way toward explaining the conservative case for MassCare. Federal law requires hospitals to provide urgent care without regard for the patient's ability to pay for the care. The cost of care that's not covered by the patient's insurance is picked up by the state.

It's this federal law that distorts the market and makes freeloading not only possible but "sensible". Why spend thousands of dollars each year on medical insurance when the feds have granted each person "basic" insurance coverage through this mandate? Enough people have responded to this incentive that many states are spending hundreds of millions of dollars on the federally mandated care.

States have no ability to change the reach of the federal law, so the states have only two tools for managing the costs associated with the federal mandate: 1) arbitrarily set the amount the state will pay healthcare providers, and 2) increase the percentage of state residents having private health insurance.

It's unclear why a conservative would prefer forcing a doctor to provide X service for $Y (where $Y may be less than the doctor's cost of providing the service) to forcing a resident to buy medical insurance, neither approach is consistent with conservative principles -- but that's the choice states face. Allow residents to free-ride by not buying insurance, cut doctor reimbursement rates below market, or allow a large part of their budget to grow unchecked. Absent a repeal of the federal law, there's no good answer to the problems created by the law.

The key question is not whether the poor are going to be covered by health insurance (they will be) but how it is done. The less statist approach is to not create a huge government bureaucracy to take over health care (as the dems have done) but to distribute vouchers that can be used to buy health insurance to those who can't afford health care.

The GOP has to realize that income redistribution is inevitable. The key battle is to keep the federal government as small, weak, and inexpensive as possible. Wherever possible, government power should be at the state level rather than the federal level.

edutcher said...As many said, Newt has baggage, but what does it say about the former Governor of MA that he still hasn't renounced the same thing?==================A recognition of reality. Left to the states, perhaps 20 or so will have voters elect to put a variant of Romneycare in place. Hopefully with major tweaks to cut costs after even Mass Dems conceeded they put too many bells and whistles in and blocked some of Romney's cost containment proposals.And the states do need to leverage buying power - like negotiating drug prices down to Canadian or Mexican costs for the same drug, and introduce far more competition between insurers. Why should Romney apologize for a system voters in many states will go with? And any good fiscal conservative is against the present system that encourages free riding and forcing taxpayers and insurance rate payers to pick up the tab. So a fiscal conservative, vs. the much less analytical "values conservative" or lala land libertarian - is for the individual mandate.

The Democrats are going to get their nominee. Even the NYT is crowing about Romney's "inevitability" today. There is a lot to like for them - either they get Obama part two or another Democrat as president.

"Then why do so many Brits who can afford to, come here for treatment?"

How many is "so many?"

That aside, no one denies that we have excellent doctors and medical facilities here...for those "who can afford to." The problem is that many Americans can't afford it, and as health care costs continue to increase,including, of course, the cost of insurance--and as unemployment increases, (and as more of those who are employed are made "independent contractors" or become temporary hires who receive no employer provided group health insurance--more and more Americans will be unable to afford the excellent health care available to the most affluent.

But that's okay...let the rabble die, and the gene pool will be improved.